Organization
ROBERT J KENNERLEY PHD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT JOHN KENNERLEY PHD (PSYCHOLOGIST)
(386) 423-9161
Entity
Organization
Contact information
Practice address
265 N CAUSEWAY, NEW SMYRNA BEACH, FL 32169-5239
(386) 423-9161
(386) 423-3094
Mailing address
265 N CAUSEWAY, NEW SMYRNA BEACH, FL 32169-5239
(386) 423-9161
(386) 423-3094
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
PY6507
FL
261QM0855X
Adolescent and Children Mental Health Clinic/Center
PY6507
FL
Other
Enumeration date
01/20/2009
Last updated
08/26/2010
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